Transarterial infusion chemotherapy for severe hepatic dysfunction and poor performance status in diffuse hepatic metastasis: A case report

Severe hepatic dysfunction and high performance status (PS) scores in patients with cancer often indicate a poor prognosis, with an estimated survival time of <3 months, making them typically candidates for palliative care. The current study presents the case of a 66-year-old male patient with prostate neuroendocrine carcinoma and diffuse hepatic metastasis, accompanied by severe hepatic dysfunction (Child-Pugh C10) and poor PS (Eastern Cooperative Oncology Group PS3). The patient was treated with transarterial infusion chemotherapy (TAI) using a reduced-dose etoposide and cisplatin regimen. After six cycles, significant tumor regression occurred. According to Response Evaluation Criteria in Solid Tumors 1.1 criteria, the response was a partial response. The patient finally succumbed, achieving a progression-free survival time of 11.05 months and an overall survival time of 18.87 months. This case indicates that, for patients with sensitive and aggressive tumors (such as prostate neuroendocrine carcinoma) who have hepatic metastasis-induced severe hepatic dysfunction and poor PS, local reduced-dose TAI therapy may be a viable option to overcome traditional treatment contraindications.